Should I be excited?
Hello. I was just curious about something. I recieved a phone call from a lady at my insurance company yesterday & she told me that my file "has been sent to review". I told her that I already knew that it was under review - & she said that it had actually gone to the one review board and that they had sent it to a physician for review. I thought that this had sounded somewhat promising & wanted to see if anyone agreed. I have a written exclusion in my policy and if they were going to deny it outright due to that then they would have already done it - right? I asked the lady if that meant that the doctor would have the "final say-so" (other then appeal if necessary of course) and she said "yes", and I asked if that also meant that the dr would base it on medical necessity - & she also said "yes". I have asked others, & they've just told me not to get excited that this lady is just a "low paid call taker without the ability to interpret a policy or make a decision". Any ideas??
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